Jonathan has tremendous expertise and knowledge about insurance plans and gives us great advice on how to pick a plan.We are very happy with the attention he gives us.
Great person!!!!
Prescription Drug Plans (Part D)
Your Prescriptions. Your Peace of Mind.
Original Medicare doesn’t cover most outpatient prescriptions, which is why many beneficiaries add a stand-alone prescription drug plan—also known as Medicare Part D. These Medicare-approved drug plans are offered by private insurers and help reduce out-of-pocket pharmacy costs for both generic and brand-name medications. If you have Medicare Part A, Part B, or both, you’re eligible to enroll in a prescription drug plan, whether on its own or alongside a Medigap drug plan. Choosing the right coverage now helps you avoid costly coverage gaps and late enrollment penalties down the road.
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Other Practice Areas at CoverCare Insurance Inc.
At CoverCare Insurance, we’ll help you compare Part D enrollment options across leading carriers, evaluating key factors like the plan’s formulary, pharmacy network, and monthly premiums. Since every plan covers medications differently, we make sure your prescriptions are included—and that your costs are predictable. Whether you’re managing chronic conditions or simply planning ahead, Medicare drug coverage plays a vital role in your long-term healthcare strategy. Let us help you find the pharmacy benefits for seniors that fit your needs, so you can stay focused on your health—not your medication bills.
Prescription Drug Plans (Part D)
You can talk about Prescription Drug Plans (Part D) with the following specialists in any of our offices:
• Jonathan Lozano
• Yudy Lozano
Related FAQs
What is Medicare Part D?
Medicare Part D is a voluntary prescription drug benefit available to all Medicare beneficiaries. It helps cover both brand-name and generic medications through private, Medicare-approved insurers.
Who is eligible for Part D coverage?
Anyone enrolled in Medicare Part A, Part B, or both can sign up for a stand-alone Part D plan (PDP) or get it bundled with a Medicare Advantage plan (MAPD).
When can I enroll in or change a Part D plan?
You can enroll during your Initial Enrollment Period, the Annual Enrollment Period (Oct 15–Dec 7), or a Special Enrollment Period (SEP) if you lose other creditable drug coverage.
What is the Part D late enrollment penalty?
If you delay enrolling without having creditable drug coverage, you’ll pay a permanent penalty—a percentage added to your premium based on how long you delayed.
How are Medicare Part D costs structured?
Costs include a monthly premium, a deductible (up to $590 in 2025), copayments/coinsurance, and a $2,000 annual out-of-pocket cap, under the 2025 Inflation Reduction Act.
What’s the Medicare coverage gap or “donut hole”?
Historically, there was a gap where beneficiaries paid more. Now, due to the ACA and Inflation Reduction Act, after initial costs, you pay 25% until reaching your out-of-pocket limit.
Which drugs are covered under my Part D plan?
Each plan has a formulary (drug list) organized into tiers. Part D plans cover FDA-approved medications in-network; coverage can change yearly.
Are vaccines covered under Part D?
Yes—Part D covers recommended adult vaccines (like shingles and pneumonia) when not covered by Part B.
Can Part D work with other drug coverage I have?
Yes, but ensure other drug coverage is creditable. If not, you may owe a penalty later. Employer or VA coverage can count if it’s deemed creditable.
What is Extra Help (Low-Income Subsidy) in Medicare?
Medicare offers the Extra Help program for low-income individuals (under ~150% FPL), which may eliminate premiums/deductibles and waive late penalties, with year-round plan changes allowed.
What is Medication Therapy Management (MTM) in my Medicare plan?
Part D plans must offer MTM services at no extra cost to eligible beneficiaries with multiple chronic conditions and high drug use, helping manage medication regimens.
Can I use preferred pharmacies in my Part D plan?
Many Part D plans feature preferred pharmacy networks offering lower copays—great for cost savings if you use covered pharmacies consistently.
How do Part D premiums compare?
Premiums vary by plan and location. In 2025, the average stand-alone Part D premium is about $46.50/month. Higher-income individuals pay additional IRMAA (Income-Related Monthly Adjustment Amount) surcharges ($13.70–$85.80).
What are the 2025 changes to Part D?
New rules include the out-of-pocket cap at $2,000, simplified cost-sharing phases, and optional payment smoothing to spread costs over the year.
Can I switch Part D plans mid-year?
Yes—if you qualify for an SEP (e.g., loss of coverage or gaining Extra Help), you can change plans outside the annual enrollment period.